Precision prognostics for cardiovascular disease in Type 2 diabetes : a systematic review and meta-analysis
(2024) In Communications medicine 4.- Abstract
BACKGROUND: Precision medicine has the potential to improve cardiovascular disease (CVD) risk prediction in individuals with Type 2 diabetes (T2D).
METHODS: We conducted a systematic review and meta-analysis of longitudinal studies to identify potentially novel prognostic factors that may improve CVD risk prediction in T2D. Out of 9380 studies identified, 416 studies met inclusion criteria. Outcomes were reported for 321 biomarker studies, 48 genetic marker studies, and 47 risk score/model studies.
RESULTS: Out of all evaluated biomarkers, only 13 showed improvement in prediction performance. Results of pooled meta-analyses, non-pooled analyses, and assessments of improvement in prediction performance and risk of bias,... (More)
BACKGROUND: Precision medicine has the potential to improve cardiovascular disease (CVD) risk prediction in individuals with Type 2 diabetes (T2D).
METHODS: We conducted a systematic review and meta-analysis of longitudinal studies to identify potentially novel prognostic factors that may improve CVD risk prediction in T2D. Out of 9380 studies identified, 416 studies met inclusion criteria. Outcomes were reported for 321 biomarker studies, 48 genetic marker studies, and 47 risk score/model studies.
RESULTS: Out of all evaluated biomarkers, only 13 showed improvement in prediction performance. Results of pooled meta-analyses, non-pooled analyses, and assessments of improvement in prediction performance and risk of bias, yielded the highest predictive utility for N-terminal pro b-type natriuretic peptide (NT-proBNP) (high-evidence), troponin-T (TnT) (moderate-evidence), triglyceride-glucose (TyG) index (moderate-evidence), Genetic Risk Score for Coronary Heart Disease (GRS-CHD) (moderate-evidence); moderate predictive utility for coronary computed tomography angiography (low-evidence), single-photon emission computed tomography (low-evidence), pulse wave velocity (moderate-evidence); and low predictive utility for C-reactive protein (moderate-evidence), coronary artery calcium score (low-evidence), galectin-3 (low-evidence), troponin-I (low-evidence), carotid plaque (low-evidence), and growth differentiation factor-15 (low-evidence). Risk scores showed modest discrimination, with lower performance in populations different from the original development cohort.
CONCLUSIONS: Despite high interest in this topic, very few studies conducted rigorous analyses to demonstrate incremental predictive utility beyond established CVD risk factors for T2D. The most promising markers identified were NT-proBNP, TnT, TyG and GRS-CHD, with the highest strength of evidence for NT-proBNP. Further research is needed to determine their clinical utility in risk stratification and management of CVD in T2D.
(Less)
- author
- Ahmad, Abrar
LU
; Lim, Lee-Ling
; Morieri, Mario Luca
; Tam, Claudia Ha-Ting
; Cheng, Feifei
; Chikowore, Tinashe
; Dudenhöffer-Pfeifer, Monika
LU
; Fitipaldi, Hugo
LU
; Huang, Chuiguo
; Kanbour, Sarah
; Sarkar, Sudipa
; Koivula, Robert Wilhelm
LU
; Motala, Ayesha A
; Tye, Sok Cin
; Yu, Gechang
; Zhang, Yingchai
; Provenzano, Michele
; Sherifali, Diana
; de Souza, Russell J
; Tobias, Deirdre Kay
; Gomez, Maria F
LU
; Ma, Ronald C W
and Mathioudakis, Nestoras
(Less) - contributor
- Franks, Paul LU
- author collaboration
- organization
- publishing date
- 2024-01-22
- type
- Contribution to journal
- publication status
- published
- subject
- in
- Communications medicine
- volume
- 4
- article number
- 11
- publisher
- Nature Publishing Group
- external identifiers
-
- pmid:38253823
- ISSN
- 2730-664X
- DOI
- 10.1038/s43856-023-00429-z
- language
- English
- LU publication?
- yes
- additional info
- © 2024. The Author(s).
- id
- eb59aa28-33f2-4abb-984d-4891d3b2a75b
- date added to LUP
- 2024-01-25 22:35:57
- date last changed
- 2024-01-26 10:00:12
@article{eb59aa28-33f2-4abb-984d-4891d3b2a75b,
abstract = {{<p>BACKGROUND: Precision medicine has the potential to improve cardiovascular disease (CVD) risk prediction in individuals with Type 2 diabetes (T2D).</p><p>METHODS: We conducted a systematic review and meta-analysis of longitudinal studies to identify potentially novel prognostic factors that may improve CVD risk prediction in T2D. Out of 9380 studies identified, 416 studies met inclusion criteria. Outcomes were reported for 321 biomarker studies, 48 genetic marker studies, and 47 risk score/model studies.</p><p>RESULTS: Out of all evaluated biomarkers, only 13 showed improvement in prediction performance. Results of pooled meta-analyses, non-pooled analyses, and assessments of improvement in prediction performance and risk of bias, yielded the highest predictive utility for N-terminal pro b-type natriuretic peptide (NT-proBNP) (high-evidence), troponin-T (TnT) (moderate-evidence), triglyceride-glucose (TyG) index (moderate-evidence), Genetic Risk Score for Coronary Heart Disease (GRS-CHD) (moderate-evidence); moderate predictive utility for coronary computed tomography angiography (low-evidence), single-photon emission computed tomography (low-evidence), pulse wave velocity (moderate-evidence); and low predictive utility for C-reactive protein (moderate-evidence), coronary artery calcium score (low-evidence), galectin-3 (low-evidence), troponin-I (low-evidence), carotid plaque (low-evidence), and growth differentiation factor-15 (low-evidence). Risk scores showed modest discrimination, with lower performance in populations different from the original development cohort.</p><p>CONCLUSIONS: Despite high interest in this topic, very few studies conducted rigorous analyses to demonstrate incremental predictive utility beyond established CVD risk factors for T2D. The most promising markers identified were NT-proBNP, TnT, TyG and GRS-CHD, with the highest strength of evidence for NT-proBNP. Further research is needed to determine their clinical utility in risk stratification and management of CVD in T2D.</p>}},
author = {{Ahmad, Abrar and Lim, Lee-Ling and Morieri, Mario Luca and Tam, Claudia Ha-Ting and Cheng, Feifei and Chikowore, Tinashe and Dudenhöffer-Pfeifer, Monika and Fitipaldi, Hugo and Huang, Chuiguo and Kanbour, Sarah and Sarkar, Sudipa and Koivula, Robert Wilhelm and Motala, Ayesha A and Tye, Sok Cin and Yu, Gechang and Zhang, Yingchai and Provenzano, Michele and Sherifali, Diana and de Souza, Russell J and Tobias, Deirdre Kay and Gomez, Maria F and Ma, Ronald C W and Mathioudakis, Nestoras}},
issn = {{2730-664X}},
language = {{eng}},
month = {{01}},
publisher = {{Nature Publishing Group}},
series = {{Communications medicine}},
title = {{Precision prognostics for cardiovascular disease in Type 2 diabetes : a systematic review and meta-analysis}},
url = {{http://dx.doi.org/10.1038/s43856-023-00429-z}},
doi = {{10.1038/s43856-023-00429-z}},
volume = {{4}},
year = {{2024}},
}